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ESAC II Hospital Care Subproject 2005–2007: patterns of antibiotic use in relation to diagnoses in 19 European hospitals in 2006, Point Prevalence Study

Abstract number: 1732_100

Erntell M., Ansari F., Goossens H., Davey for the ESAC II HC Subproject Working Group P.

Objectives: 19 European hospitals performed a descriptive pilot Point Prevalence Study (PPS) of antimicrobial use in relation to diagnoses in European hospitals.

Method: The protocol was designed to present demographic data as well as the amounts and indications for antimicrobial agents against bacteria. Treatments were recorded in relation to diagnoses, prophylactic use, community acquired (CAI) and hospital acquired infection (HAI). 19 pre-defined diagnosis groups were used. The previously presented STRAMA protocol and web-based reporting system was used.

Results: 19 hospitals participated in the study. 3,398 patients treated with antimicrobial agents were included out of 11,224 admitted. 30% of the patients were treated with antimicrobials. 3,554 treatments were recorded. 377 (10.6%) were given to children (<17 years) and 47.6% to women. The indication for treatment was CAI in 15%, HAI in 9.2% and prophylaxis in 7.6%. For adults cultures were taken before parenteral treatment in 57% and oral treatment in 51%. The most commonly used antimicrobials for adults, in DDD, in treatment and prophylaxis were penicillins with betalactamase inhibitors (23%, 0–75, and 26%, 0–66), cephalosporins (14%, 4–38, and 30%, 0–60), fluoroquinolones (14%, 8–31, and 11%, 0–52). The total amount of antimicrobials used for adults was 52 DDD/100 admitted patients (33–88). Two diagnosis groups were predominating; pneumonia (19% of all therapies) and skin and soft tissue infections (13%). Analysis of antibiotic usage in different countries shows countries having mainly penicillins with betalactamase inhibitor or cephalosporins as the predominating drug. Seven countries showed a more varied use of drugs. The patterns of treatment and prophylactic usage were similar in countries with heavy use of one ATC-class. Length of peri-operative prophylaxis was dominated by >1 day in all surgical specialities; in general surgery 59%, in orthopaedic surgery 52%, in urology 76% and in ENT 89%. One-dose peri-operative prophylaxis ranged from 2% to 27%. One-day prophylaxis was 34% in orthopaedic surgery.

Conclusions: The study describes wide differences (three fold) in consumption between European hospitals. Peri-operative prophylaxis is too long in all surgical specialities. There is limited variation in the use of different antibiotic groups in most hospitals – a risk factor for emergence of antibiotic resistance. Our web-based PPS provides a tool for quality assessment of antibiotic prescribing in European hospitals.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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